Background: Transmitted drug-resistance (TDR) remains a critical aspect for the management of HIV-1-infected individuals. Thus, studying the dynamics of TDR is crucial to optimize HIV care.Methods: In total, 4323 HIV-1 protease/reverse-transcriptase sequences from drug-naive individuals diagnosed in north and central Italy between 2000 and 2014 were analysed. TDR was evaluated over time. Maximum-likelihood and Bayesian phylogenetic trees with bootstrap and Bayesian-probability supports defined transmission clusters.Results: Most individuals were males (80.2%) and Italian (72.1%), with a median (IQR) age of 37 (30-45) years. MSM accounted for 42.2% of cases, followed by heterosexuals (36.4%). Non-B subtype infections accounted for 30.8% of the overall population and increased over time (<2005-14: 19.5%-38.5%, P<0.0001), particularly among Italians (<2005-14: 6.5%-28.8%, P<0.0001). TDR prevalence was 8.8% and increased over time in non-B subtypes (<2005-14: 2%-7.1%, P=0.018). Overall, 467 transmission clusters (involving 1207 individuals; 27.9%) were identified. The prevalence of individuals grouping in transmission clusters increased over time in both B (<2005-14: 12.9%-33.5%, P=0.001) and non-B subtypes (<2005-14: 18.4%-41.9%, P=0.006). TDR transmission clusters were 13.3% within the overall cluster observed and dramatically increased in recent years (<2005-14: 14.3%-35.5%, P=0.005). This recent increase was mainly due to non-B subtype-infected individuals, who were also more frequently involved in large transmission clusters than those infected with a B subtype [median number of individuals in transmission clusters: 7 (IQR 6-19) versus 4 (3-4), P=0.047].Conclusions: The epidemiology of HIV transmission changed greatly over time; the increasing number of transmission clusters (sometimes with drug resistance) shows that detection and proper treatment of the multitransmitters is a major target for controlling HIV spread.

Fabeni, L., Alteri, C., Di Carlo, D., Orchi, N., Carioti, L., Bertoli, A., et al. (2017). Dynamics and phylogenetic relationships of HIV-1 transmitted drug resistance according to subtype in Italy over the years 2000-14. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 72(10), 2837-2845 [10.1093/jac/dkx231].

Dynamics and phylogenetic relationships of HIV-1 transmitted drug resistance according to subtype in Italy over the years 2000-14

Fabeni L;Alteri C;Bertoli A;Maffongelli G;Cristaudo A;Andreoni M;Ceccherini-Silberstein F;Perno CF;Santoro MM;Vullo V;Sarmati L;BUONOMINI, ANNA RITA;MASTROIANNI, CHIARA;
2017

Abstract

Background: Transmitted drug-resistance (TDR) remains a critical aspect for the management of HIV-1-infected individuals. Thus, studying the dynamics of TDR is crucial to optimize HIV care.Methods: In total, 4323 HIV-1 protease/reverse-transcriptase sequences from drug-naive individuals diagnosed in north and central Italy between 2000 and 2014 were analysed. TDR was evaluated over time. Maximum-likelihood and Bayesian phylogenetic trees with bootstrap and Bayesian-probability supports defined transmission clusters.Results: Most individuals were males (80.2%) and Italian (72.1%), with a median (IQR) age of 37 (30-45) years. MSM accounted for 42.2% of cases, followed by heterosexuals (36.4%). Non-B subtype infections accounted for 30.8% of the overall population and increased over time (<2005-14: 19.5%-38.5%, P<0.0001), particularly among Italians (<2005-14: 6.5%-28.8%, P<0.0001). TDR prevalence was 8.8% and increased over time in non-B subtypes (<2005-14: 2%-7.1%, P=0.018). Overall, 467 transmission clusters (involving 1207 individuals; 27.9%) were identified. The prevalence of individuals grouping in transmission clusters increased over time in both B (<2005-14: 12.9%-33.5%, P=0.001) and non-B subtypes (<2005-14: 18.4%-41.9%, P=0.006). TDR transmission clusters were 13.3% within the overall cluster observed and dramatically increased in recent years (<2005-14: 14.3%-35.5%, P=0.005). This recent increase was mainly due to non-B subtype-infected individuals, who were also more frequently involved in large transmission clusters than those infected with a B subtype [median number of individuals in transmission clusters: 7 (IQR 6-19) versus 4 (3-4), P=0.047].Conclusions: The epidemiology of HIV transmission changed greatly over time; the increasing number of transmission clusters (sometimes with drug resistance) shows that detection and proper treatment of the multitransmitters is a major target for controlling HIV spread.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore MED/07 - Microbiologia e Microbiologia Clinica
English
Con Impact Factor ISI
Fabeni, L., Alteri, C., Di Carlo, D., Orchi, N., Carioti, L., Bertoli, A., et al. (2017). Dynamics and phylogenetic relationships of HIV-1 transmitted drug resistance according to subtype in Italy over the years 2000-14. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 72(10), 2837-2845 [10.1093/jac/dkx231].
Fabeni, L; Alteri, C; Di Carlo, D; Orchi, N; Carioti, L; Bertoli, A; Gori, C; Forbici, F; Continenza, F; Maffongelli, G; Pinnetti, C; Vergori, A; Mondi, A; Ammassari, A; Borghi, V; Giuliani, M; De Carli, G; Pittalis, S; Grisetti, S; Pennica, A; Mastroianni, C; Montella, F; Cristaudo, A; Mussini, C; Girardi, E; Andreoni, M; Antinori, A; Ceccherini-Silberstein, F; Perno, C; Santoro, M; Capobianchi, M; Navarra, A; Palummieria, ; Abbate, I; D'Arrigo, R; Fusco, F; Mariano, A; Nicastri, E; Nurra, G; Puro, V; Sampaolesi, A; Sciarrone, M; Scognamiglio, P; Selleri, M; Sias, C; Zaccarelli, M; Di Carlo, A; Giuliani, M; Vullo, V; Falciano, M; Errigo, F; Gattari, P; Spizzichino, L; Schito, S; Sarmati, L; Buonomini, Ar; Cerva, C; Mastroianni, C; Lichtner, M; Mercurio, V; Anzalone, E; Pitorri, A; Caterini, A; Barbacci, S
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/194918
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